And with 12 years as Chief Executive at his FT, he is a shining NHS example of what makes successful organisations …………successful.

Led by Jeff Immelt, CEO at General Electric, a study found one key trait that is common in all successful companies. Their managers stay in place for along time.

Staying in place for along time, gives them space to extend their abilities, to learn much more about their organisation, to develop the critical connections that make their organisations perform better.

This is what Stephen Ramsden did, as a Chief Executive at Luton and Dunstable. Medical staff become successful because they take similar speciality-specific steps to extend their abilities, to learn about their speciality and to develop critical connections.

Immelt also found the converse, asserting that ‘the places where we’ve churned people like reinsurance, are the places where you will find we’ve failed’. We’ve had examples in the NHS where people are ‘churned like reinsurance’.

We need more Stephen Ramsdens, not less!. And in turn, they need the support of their Boards, their employees, SHAs, Monitor, Governors and other key stakeholders.

Chief Executives need the time and space to get to know their organisations much better, to extent their personal abilities, to develop critical connections, to understand risks and how to manage them effectively.

And in return they will be better placed to ensure that their NHS organisations wrestle with the very real risks of escalating demand and constraining resources.

In each year since 2000, Mike O’Brien and his colleagues in the Blair/Brown Governments, increased their funding of the NHS in England by almost 7% (on average).

And now we are preparing for annual funding increases that will be much closer to 0%. David Nicholson told us earlier this year that the NHS needs to find £15bn-£20bn of savings by 2014. The NHS has two options.

The first is to hit the target and miss the point.

By reducing inputs - cutting staff, closing buildings and increasing waiting lists. Its refreshing that Mike O’Brien does not want to see budgets and services slashed in response to the public sector funding squeeze.

Hitting the target and missing the point would be costly. Patients would not be interested in why NHS services were being cut. They would not want explanations as to why there were less staff on-duty.

Patients expect a return on their investment - for the National Insurance Contributions that they have and/or are making. And my guess is that patients will continue to expect better healthcare.

The second option is to hit the target …. and to hit the point.

By reducing waste in core processes, such as diagnosing, treating, and communicating with patients. By getting the care of patients right first time. By reducing unnecessary readmissions.

By ensuring that clinicians and managers feel empowered to achieve results, to make changes, to take decisions, to drive service improvement, to actively deal with risk.

The NHS is likely to reduce waste in core processes, when Directors of Finance and their colleagues become even more actively involved in process improvement and removing waste. When they continue allocating serious investment in the development of improvement capability. By continuing to focus on cost per unit, and not expecting increased funding from the Government or elsewhere.

My guess is that Mike O’Brien will not ‘name and shame’. Because the NHS will actively work to reduce waste in its core processes. And that the NHS will find the £15-£20bn of savings by 2014. And because Mike O’Brien and David Nicholson will continue to speak the same language.

Listening to Evan Davis on BBC Radio 4, I was particularly interested in the language of his guests.

James Dyson introduced himself as the founder of vacuum cleaners that work better.

Marta Lane Fox, recently appointed Champion of Digital Inclusion, is working to make life better for the six million economically and socially disadvantaged people in the UK that have no access to technology.

And Adrian Ringrose  the chief executive of a company that enables public sector organisations do what they do, by doing all the bits that these organisations don’t want to think about.

When introducing ourselves in the NHS, we tend to use different language. And this episode of BBC Radio 4’s The Bottom Line promised a lot. It was a discussion about creativity and innovation.

To be good at innovation and creativity, Martha Lane Fox said that boldness and self-confidence works for her. James Dyson added that innovation for him is caring about solving problems and taking little incremental steps to get there.

And Adrian Ringrose gave his insight into the public sector. He suggested that it is more important to do what we do in the public sector - by the rules, rather than focusing on the end game.

A generalisation perhaps, he reminded us that it is the end point that matters and we are more likely to get there by building on our mistakes.

And my guess is that this point resonates with you and many leaders in NHS risk management, governance and safety. I enjoyed this edition of BBC Radio 4’s The Bottom Line and I know that you will too.

The NHS Institute has been an exciting place to work. During my 18 months with them, I led the development of their intranet-based risk register and board assurance framework, standing orders, standing financial instructions and scheme of delegation.

As well as being a key link between the Institute and the Department of Health, I was actively involved in developing their balanced scorecard; sustainable development; reviewing the security of their people, buildings and information; the procurement of health and safety training and risk assessment services and lots more besides.

Working with the NHS Institute meant a lot me. Over the 18 months, it has transformed into an outward looking, customer-focussed organisation. Whenever I hear about NHS Live, Knowledge Management, World Class Commissioning, the Management Training Schemes, the Productives, Safer Care series … I’ll think of them.

And I’m looking forward to my next assignment at NHS Stoke on Trent.

A colleague mentioned this morning that today is World Book Day. And she asked me if I have a favourite book.  I mentioned the one that I like a lot.

Five Minds for the Future sets out to help us survive and prosper with increasing technology, globalisation and diversity. And unsurprisingly, it is how we think that will be the key to our success. There are five mind-types that will maximise our success.

Knowing something really well, being an expert in surgery, or management, or safer care and keeping it up, are examples of the disciplined mind.

And the synthesising mind is about the information that we receive. What do we pay attention to and what de we ignore, how do we put it together in a way that makes sense to us?

The creating mind is about coming up with something new that eventually affects how other people are and how they think.

When it comes to thinking out of the box, the disciplined and synthesising minds provide the box and for many of us, that’s enough. But for the cutting-edge few, it’s the thinking and doing stuff that really ends up benefiting lots of people.

Our respectful mind enables us to give others the benefit of the doubt, getting to know them, understanding them, suspending judgement and being capable of forgiveness. And the respectful mind is acutely important because of the diverse society we live in.

And the ethical mind is capable of abstraction. This is where we can think about ourselves abstracting. The ethical mind asks what our responsibilities are, what our responsibilities are as residents of where we live, the UK, of the planet?

So much for the theory. And what about this in practice. We can reflect on the extent to which our minds embody discipline, synthesising, creativity, respect and ethics.

And within independent consultancy, respect and ethics are vital. Unless we retain our atmosphere of respect, colleagues and customers will probably not trust us and relations are likely to deteriorate.

Of course we cannot guarantee that our customers will be respectful and ethical. And as we embody these virtues in our interactions, the chances are enhanced that they will reciprocate.

Joined twitter today and I’m delighted with the amount of information on there. About celebrities, the M5, Universities, BMJ, newspapers and three NHS Trusts - buckinghamshire hospitals, oxford radcliffe, and southampton university hospitals.

With twitter, I can follow other twitter’ers and be followed. Already being followed by two sites and I’m following 42 twitter sites.

And best of all, I can see all of their tweets chronogically. My profile is http://twitter.com/patrickkeady

This morning I received an INLPTA Certificate from David Smallwood, for completing the NLP Master Practitioner course.

David is a certified trainer of business-focused NLP, a certified NLP health practitioner and a certified INLPTA trainer. And he was my principal trainer throughout all of my NLP training at diploma, practitioner and master practitioner levels. David is a wonderful inspiration, an excellent trainer and unbeatable value for money too.

Having completed the NLP practitioner course last year, David commented that it was during the master practitioner training that I really demonstrated the integration of my Practitioner training.

A number of people have asked what the NLP master practitioner training is all about and how it differs from NLP practitioner training.

While I had the skills and understanding of an NLP practitioner, the master practitioner training leveraged my learning from there to go to levels of competency that to an untrained observer might appear amazing. See what Richard Bandler has to say about master practitioner training.

While the focus in practitioner training was on learning the fundamentals, the master practitioner training was about Mastery. This brought with it new levels of understanding and skills development so that I am now able to run the NLP patterns as well as able to tailor, re-organise, and even make new patterns on my own that are appropriate to the situation in hand.

I learned new distinctions and developed new skills and David trained us with his eye on precision and elegance. The epistemology of the master practitioner training was very different too from that of the practitioner - in terms of outcomes, behaviours, ways of being, and ways of relating to the world.

The master practitioner training was about me and the many routes open to me to achieve my outcomes, my better outcomes. It was about my ability to facilitate behavioural change and to do so elegantly, generatively, and with precision.

‘Without a national study, politicians and health professionals go into denial ….. we don’t have a problem’. This was one of the comments for Sir Liam Donaldson when he opened the Patient Safety Research Portfolio Conference this morning at the Royal College of Physicians

Speaking to a selection of the researchers that participated in the 36 patient safety research projects undertaken over seven years, at a cost of about 70p per NHS England employee per annum. He outlined his vision of the ten contributions that patient safety research offers to improving healthcare, as follows:

•    increasing awareness of patient safety - with clinicians, provider organisations and commissioners
•    understanding the causes of patient (un)safe-ty – and in relation to sleep deprivation, Sir Liam reminded us of the importance of the 48 hour week - clinicians are more likely to kill patients when they are tired.
•    more research in the young discipline of patient safety will enhance safety and improve productivity
•    establishing conceptual concepts - to enhance the ‘poverty of concepts in patient safety’
•    developing solutions – including improved design in healthcare, a recurring theme throughout the day
•    setting standards for information – before and after studies, randomised control trials etc
•    informing evidence based care
•    evaluating progress including checklists - twice as effective as education
•    nurturing researchers
•    and promoting leaders in patient safety

Professor Richard Lilford oversaw the Patient Safety Research Portfolio from its inception and this morning, he highlighted some of the successes of the programme. These included Professor Nick Barber’s discovery that nursing homes openly welcomed the prospect of his team observing medication errors and recommending improvements – their willingness could be related to the significant amount of time that care home staff spend in medication-related activities.

The day was chaired by Professor Paul Barach, one of the best Chairs that I’ve seen at a healthcare seminar/conference. He has has a very rare ability. He keeps the audience interested, even during the ‘graveyard shift’.  And he ensured that all 17 leaders in patient safety research, delivered their presentations in less than 4 hours. Now that is a rare achievement.

Citing an (unnamed) study elsewhere in the world, we heard that 9% of clinicians wash their hands before they touch a patient in the operating room and 17% do so after they touch the patient. Enter Professor Sheldon Stone summarising the successes of the Clean Your Hands campaign – and reminding us of the rationale for the campaign - 8% of patients acquire healthcare associated infections and their mortality is six times higher. Direct contact by hand is the main route of infection and Sheldon delivered this very serious message, in an entertaining way.

Chris Fuller described HHOT – the hand hygiene observation tool and Professor George Hanna told us about the checking procedures developed by his team for naso-gastric tubes. Dr Rebecca Lawton highlighted the success and lessons learned in evaluating non-luer spinal connectors.

While risk metrices represent risk and are almost universal in healthcare, Professor John Clarkson highlighted their limitations - they lack a systematic approach. And this is why he and his team are developing a toolbox for healthcare, that will include risk assessment models and tools and a process for escalating the higher risks.

Dr Karin Lowson’s insight into single hospital rooms, was topical and revealing. Patients in single rooms are more satisfied. They are less likely to acquire infection experience medication errors during their hospital stay. That said, some patient in single rooms are more likely to die and experience depression. And the risk of an adverse event and length of stay are about the same for patients in wards and in single rooms.

Much has been said about enhancing the patient safety agenda on the curricula of healthcare professionals. And recommendations as to this an be achieved, were provided by Dr Pauline Pearson and Professor Amanda Howe.

Professor Ian Watt gave an overview of how patients can ensire that clinicians deliver safe patient care – by making sure that the treatment is appropriate for them, that the treatment is as planned and in accordance with the appropriate protocol, and identifying how the health system can be made safer.

Dr Ken Catchpole shared his line of enquiry in operating theatres and elsewhere in healthcare. And he has four key questions. Is the healthcare team’s approach consistent with achieving high standards of care. Is what they are doing acceptable for Ken and his family. Does what the team are doing have to be like this. Is this the best it can be? Simple questions, revealing answers.

And Professor Mary Dixon-Woods outlined six rules for governance in operating theatres. The organisation is geared to promote patient safety. Protocols are deployed appropriately and everyone serves their spirit. Optimum communication. Minimal distraction and interruption. Effective authority and accountability. Reporting patient safety incidents.

Professor Justin Waring is in the process of summarising the outputs from the PSRP under the broad headings of the nature of patient safety, sources of risk and safety, and identifying the future direction for research.

And Martin Fletcher was the final speaker, talking about the science of safety. The NPSA Chief Executive sees the patient safety research agenda developing by networking the researchers, funding more PhD students and running another UK patient safety research conference.
Some of the many highlights for me were hearing about the science of safety, Ken Catchpole’s approach to enquiry in patient safety, how patients can be more assertive, updating the curricula, design of hospitals and non-luer spinal connectors, prospective analysis, competency based training in naso-gastric tubes and handwashing, observing hand hygiene, the benefits and weaknesses of focusing on improving culture and CHUMS.

With many thanks to Sir Liam Donaldson, Professor Lilford, the PSRP team and all of the researchers for making this fantastic conference a reality.

You like where you live. You love your job. Maybe you don’t. Want to move? And not sure where to? Maybe you’d like to move to four different places all at once. Or you want to remind yourself just why you love where you live. Then, Who’s Your City? place finder is for you.

Just list where you live now and up to four other places where you’d like to live. Answer 10 questions and place finder will reflect back to you the place that’s best  suited to you. And those that don’t too.

If you like the website, then you’ll love Richard Florida’s book. Who’s Your City? How the Creative Economy Is Making Where You Live the Most Important Decision of Your Life.